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Borage Oil (Starflower Oil)

Borago officinalis
Evidence Level
Limited
6 Clinical Trials
3 Documented Benefits
2/5 Evidence Score

Borage oil (starflower oil) is pressed from the seeds of Borago officinalis and is taken for its gamma-linolenic acid (GLA), an omega-6 fatty acid. Borage oil used in clinical trials contained at least 23 percent GLA, against about 10 percent in evening primrose oil, so fewer capsules supply the same GLA. The human evidence is narrow. In one placebo-controlled trial in 37 adults with rheumatoid arthritis, borage seed oil supplying 1.4 g of GLA a day gave better overall responses than placebo; that trial and the later ones come from one research group. A review of 27 eczema trials, 8 of them with borage oil, found no benefit over placebo, and a small study in healthy women with dry skin found one skin measure better than placebo while hydration and water loss were not shown to be. The borage plant contains liver-toxic pyrrolizidine alkaloids, so choose seed oil tested for them.

Studied Dose No established dose. Joint trial: borage seed oil supplying 1.4 g GLA a day (about 6 g of oil) for 24 weeks. Skin trials: 500 mg to 2.2 g of oil a day, or 920 mg GLA a day in adults. A 1,000 mg softgel at 23 percent GLA supplies about 230 mg GLA.
Active Compound Gamma-linolenic acid (GLA), at least 23 percent of the oil in trial products

Benefits

Concentrated Source of Gamma-Linolenic Acid (GLA)

Borage oil used in clinical trials contained at least 23 percent GLA, against about 10 percent in evening primrose oil, so fewer capsules supply the same amount. This describes composition, not a health outcome: none of the trials cited here compared it with another GLA oil, and in an 18-month trial it did no better than fish oil.

Supported by Trial 2, Trial 1

Joint Tenderness and Swelling Support

In a 24-week placebo-controlled trial in 37 adults with rheumatoid arthritis, borage seed oil supplying 1.4 g of GLA a day (about 6 g of oil) gave better overall responses than placebo, with fewer tender and swollen joints. A later 18-month trial found borage oil no different from fish oil but had no placebo group. Both come from one research group, and in the later trial patients stayed on stable usual medication.

Supported by Trial 1, Trial 2

Skin Reddening Response in Healthy Women

In a 12-week placebo-controlled study in 45 healthy women with dry skin, 2.2 g a day of borage oil lessened skin reddening after a chemical irritant more than placebo did, although the placebo group started lower. Hydration, water loss and roughness were not shown to differ from placebo. Placebo-controlled eczema trials found no benefit, and hair and nails were never measured.

Supported by Trial 3

Mechanism of action

1

GLA to DGLA and Series-1 Prostaglandins

The body converts GLA to dihomo-gamma-linolenic acid (DGLA), which can form series-1 prostaglandins such as PGE1 and a derivative that blocks conversion of arachidonic acid to leukotrienes. This is the rationale for an anti-inflammatory effect, not proof of one: eczema trials built on the same idea were null.

2

Bypassing the Delta-6 Desaturase Step

Making GLA from linoleic acid requires the enzyme delta-6 desaturase, and human skin cannot make GLA itself. Taking GLA directly skips that step: in older adults, two months of borage oil raised GLA by about 70 percent and DGLA by about 18 percent in red blood cell membranes.

3

Skin Barrier Lipids

Linoleic acid and GLA are part of the skin's barrier lipids. In practice, a placebo-controlled study did not show a between-group difference in water loss through the skin for borage oil, and an uncontrolled study in older adults reported a drop of about 11 percent with no comparison group.

Clinical trials

1
Borage Seed Oil for Joint Tenderness and Swelling
PubMed

Randomized, double-blind, placebo-controlled 24-week trial in a university hospital rheumatology clinic: borage seed oil supplying 1.4 g/day GLA (about 6 g of oil) versus cottonseed oil placebo in rheumatoid arthritis (Leventhal et al. 1993, Ann Intern Med)

37 adults with rheumatoid arthritis and active joint inflammation

Borage seed oil reduced signs and symptoms of disease activity (P < 0.05) while the placebo group showed no change or worsened, and overall clinical response across four measures was better than on placebo (P < 0.05). Tender joint count fell 36 percent and swollen joint count 28 percent on borage oil, while the placebo group did not improve significantly on any measure. No one stopped borage oil because of side effects.

2
Borage Seed Oil Versus Fish Oil Over 18 Months
PubMed

Randomized, double-blind 18-month trial with no placebo group in rheumatoid arthritis patients on stable usual medication: borage seed oil (1.8 g/day GLA), fish oil, or both; same research group as the earlier trials (Reed et al. 2014, Evid Based Complement Alternat Med)

150 adults randomized, about 26 per group at 18 months

Disease activity scores fell in all three groups by 9 months and stayed lower to 18 months, with no significant difference between borage oil, fish oil and the combination. With no placebo group, the trial cannot show that the oils caused the improvement.

3
Borage Oil and Skin Condition in Healthy Women
PubMed

Randomized, double-blind, placebo-controlled 12-week study of 2.2 g/day borage oil, flaxseed oil or a medium-chain fat placebo; two authors worked for the supplement maker Laboratoire Oenobiol (De Spirt et al. 2009, Br J Nutr)

45 healthy women with dry, sensitive skin, 15 per group

Reddening after a nicotinate irritant fell more on borage oil than on placebo (P = 0.03 at 6 and 12 weeks), though the placebo group started lower. Hydration rose in all groups with no difference from placebo, and water loss through the skin and roughness on borage oil were not reported as different from placebo.

4
Borage Oil in Adults and Children: 12-Week Placebo Trial
PubMed

Randomized, double-blind, placebo-controlled trial in atopic eczema, adults 920 mg/day GLA; sponsored by Essential Nutrition Ltd, whose director was an author (Takwale et al. 2003, BMJ)

151 patients randomized, 140 evaluable including 69 children

The primary sign score improved slightly more on placebo (difference 1.4 points in favor of placebo, P = 0.45), and no other assessment differed between groups. The authors concluded GLA is not beneficial for this condition.

5
Borage Oil 500 mg Daily for 24 Weeks
PubMed

Double-blind, placebo-controlled multicenter trial in adults with stable moderate atopic eczema; primary outcome was use of rescue steroid cream (Henz et al. 1999, Br J Dermatol)

160 adults randomized

The primary outcome did not differ significantly from placebo, so the trial was negative overall. Several symptoms improved more than on placebo, and a benefit appeared only in a subgroup that excluded patients whose blood DGLA did not rise.

6
Borage Oil Supplement in Formula-Fed Infants
PubMed

Randomized, double-blind, placebo-controlled prevention trial of borage oil (100 mg/day GLA) versus sunflower oil for the first 6 months of life in infants at high family risk of atopic dermatitis (van Gool et al. 2003, Am J Clin Nutr)

118 formula-fed infants with a maternal history of allergic disease

No significant effect on whether the condition developed in the first year or on total IgE at one year; severity showed a nonsignificant trend in favor of borage oil (P = 0.09).

Side effects and drug interactions

Common Potential side effects

Digestive upset: in the eczema trials pooled by a Cochrane review, borage and evening primrose oil had the same fairly common, mild, short-lived side effects as placebo, mainly gastrointestinal. Those trials were short and did not examine long-term use. In rheumatoid arthritis trials of GLA oils, a Cochrane review counted adverse events in 20 percent on GLA versus 3 percent on placebo, a difference that was not statistically significant.
Pyrrolizidine alkaloids: the borage plant contains these liver-toxic compounds. A sensitive test of one commercial borage seed oil found none above about 200 parts per trillion, but NIH LactMed says seed oil may contain small amounts and advises products certified free of them, so ask the seller for a test result. For herbal medicines, the European Medicines Agency's 2021 statement sets an acceptable intake of 1.0 microgram a day for an adult (0.5 microgram for a 20 kg child), replacing the 0.35 microgram figure of its 2014 version; the European Food Safety Authority judged a tolerable daily intake inappropriate for these alkaloids.
Seizures: a 2011 case report describes status epilepticus in a patient who had taken borage oil for one week. A single case cannot show cause, and a 2007 review judged the older evening primrose oil seizure reports spurious, but anyone with a seizure disorder should ask their prescriber before use.
Bleeding: the Cochrane eczema review cites a study finding that evening primrose oil, another GLA oil, may increase bleeding in people taking warfarin. Tell your surgeon or dentist you take borage oil before a planned procedure.
Pregnancy and breastfeeding: the European Medicines Agency notes that pyrrolizidine alkaloids cross the placenta in rats and harm suckling young in animal studies. NIH LactMed says only borage seed oil certified free of these alkaloids should be used while nursing. Ask your doctor before use.

Important Drug interactions

Warfarin and other blood thinners: the Cochrane eczema review cites a study finding that evening primrose oil, another GLA oil, may increase bleeding in people taking warfarin. Ask your prescriber before combining borage oil with anticoagulant or antiplatelet medicines.
Antiseizure medicines: a case report describes status epilepticus after a week of borage oil. A 2007 review judged the older evening primrose oil seizure reports spurious, so the link is unproven, but people treated for seizures should check with their prescriber first.
Medicines or substances that strain the liver, including alcohol: the European Medicines Agency notes that pyrrolizidine alkaloids act together with other liver toxins such as aflatoxin and alcohol in laboratory and animal studies. This matters only if the oil contains these alkaloids, so choose tested oil.

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Frequently asked questions about Borage Oil (Starflower Oil)

What is borage oil?

Borage oil, also called starflower oil, is pressed from the seeds of the borage plant (Borago officinalis) and is taken as a source of gamma-linolenic acid (GLA), an omega-6 fatty acid. Borage leaf and flower are different products that naturally contain liver-toxic pyrrolizidine alkaloids; the seed oil may contain small amounts, so tested products matter.

What is Borage Oil used for?

Its best-studied use is joint comfort: one placebo-controlled trial in 37 adults with rheumatoid arthritis found better responses on borage seed oil supplying 1.4 g of GLA a day, several times what a standard softgel provides, and patients stayed on usual medication. Skin is the other common use, but a Cochrane review of 27 eczema trials found no benefit over placebo, and in healthy women only one skin measure beat placebo.

What is the recommended dosage of Borage Oil?

There is no established dose. The joint trial used borage seed oil supplying 1.4 g of GLA a day (about 6 g of oil), and the skin studies used 500 mg to 2.2 g of oil a day. A 1,000 mg softgel at 23 percent GLA supplies about 230 mg GLA, so a label dose is far below the joint trial dose. Follow the product label and ask your doctor about higher amounts.

Is Borage Oil safe, and does it have side effects?

In short eczema trials, side effects were mild and mainly digestive and matched placebo; in arthritis trials of GLA oils they were more frequent than on placebo, though not significantly. Long-term use has not been studied. The plant contains liver-toxic pyrrolizidine alkaloids, so choose seed oil certified free of them. A related GLA oil may increase bleeding with warfarin, one case report links borage oil to a prolonged seizure, and pregnant or nursing women should ask a doctor first.

What did the borage oil skin trials find?

Placebo-controlled trials in eczema were negative: a 140-person trial sponsored by a supplement company found placebo did slightly better, a 160-person trial missed its main outcome, and an infant prevention trial found no effect. In 45 healthy women, borage oil reduced reddening after an irritant more than placebo, but hydration, water loss and roughness were not shown to differ.

Has GLA been tested for cyclic breast pain or nerve function?

Breast pain trials used evening primrose oil or GLA, not borage oil, and found no benefit over placebo oils in 555 and 120 women, and a review judged evening primrose oil of little value for premenstrual symptoms. A one-year trial of 480 mg GLA a day in 111 people with mild diabetic neuropathy reported better nerve measures than placebo, but the abstract names no borage oil product, so it does not show what borage oil itself does.

Does Borage Oil interact with any medications?

Possible interactions include: Warfarin and other blood thinners: the Cochrane eczema review cites a study finding that evening primrose oil, another GLA oil, may increase bleeding in people taking warfarin. Ask your prescriber before combining borage oil with anticoagulant or antiplatelet medicines. If you take prescription medication, check with a pharmacist or doctor before using it.

How strong is the scientific evidence for Borage Oil?

NutraSmarts rates the evidence for Borage Oil as Limited (2 out of 5). It is backed by 6 study summaries and 21 cited references summarized on this page. A higher rating reflects more, larger, and better-designed human studies.

References(21 citations)

Evidence ratings on NutraSmarts are based on the totality of human clinical research, with emphasis on randomized controlled trials, meta-analyses, and systematic reviews. The references below directly support claims made throughout this page.

  1. Bamford JT, Ray S, Musekiwa A, van Gool C, Humphreys R, Ernst E. Oral evening primrose oil and borage oil for eczema. Cochrane Database Syst Rev. 2013;2013(4):CD004416. doi: 10.1002/14651858.CD004416.pub2.PubMedUsed to support: Systematic review of 27 randomized trials in 1,596 people, 8 of them using borage oil, testing oral evening primrose or borage oil for eczema. Neither oil improved global eczema symptoms compared with placebo, as rated either by patients or by doctors, and the reviewers judged the confidence intervals narrow enough that further trials would be hard to justify. This is why the skin section on this page does not claim an eczema benefit. Reported adverse effects were the same fairly common, mild, short-lived ones seen on placebo, mainly gastrointestinal, and the review notes a study finding that evening primrose oil may increase bleeding with warfarin. The lead author's own earlier evening primrose oil research was funded by a foundation grant repaid by the maker Efamol, which supplied the study materials; he did not select or extract that trial's data for the review.
  2. Henz BM, Jablonska S, van de Kerkhof PC, Stingl G, Blaszczyk M, Vandervalk PG, Veenhuizen R, Muggli R, Raederstorff D. Double-blind, multicentre analysis of the efficacy of borage oil in patients with atopic eczema. Br J Dermatol. 1999;140(4):685-8. doi: 10.1046/j.1365-2133.1999.02771.x.PubMedUsed to support: Double-blind multicenter trial in 160 adults with stable, moderate atopic eczema taking 500 mg of borage oil (at least 23 percent GLA) or a miglyol placebo daily for 24 weeks, with rescue steroid cream use as the primary measure. The overall response did not reach statistical significance, so the trial was negative on its main outcome; several symptoms improved more than on placebo, and significant differences favoring borage oil appeared only in a subgroup that excluded patients whose red cell DGLA did not rise and whose adherence was questionable. The background notes that evening primrose oil contains about 10 percent GLA.
  3. van Gool CJ, Thijs C, Henquet CJ, van Houwelingen AC, Dagnelie PC, Schrander J, Menheere PP, van den brandt PA. Gamma-linolenic acid supplementation for prophylaxis of atopic dermatitis--a randomized controlled trial in infants at high familial risk. Am J Clin Nutr. 2003;77(4):943-51. doi: 10.1093/ajcn/77.4.943.PubMedUsed to support: Double blind placebo controlled prevention trial in 118 formula fed infants with a maternal history of allergic disease, given borage oil supplying 100 mg of GLA daily for the first six months of life. It did not prevent atopic dermatitis and did not change total IgE at one year; severity showed only a trend in favor of GLA that did not reach significance. This is a prevention study in infants rather than a treatment study in adults, and it did not find a benefit.
  4. Zurier RB, Rossetti RG, Jacobson EW, DeMarco DM, Liu NY, Temming JE, White BM, Laposata M. gamma-Linolenic acid treatment of rheumatoid arthritis. A randomized, placebo-controlled trial. Arthritis Rheum. 1996;39(11):1808-17. doi: 10.1002/art.1780391106.PubMedUsed to support: Randomized placebo-controlled trial in 56 patients with active rheumatoid arthritis, using 2.8 g/day of GLA as the purified free fatty acid against a sunflower seed oil placebo for 6 months, followed by 6 single-blind months in which everyone received GLA. Meaningful improvement in four measures occurred in 14 of 22 patients on GLA versus 4 of 19 on placebo (P = 0.015). The GLA was a purified fatty acid, not borage oil, so this trial supports GLA in general rather than borage oil itself.
  5. Leventhal LJ, Boyce EG, Zurier RB. Treatment of rheumatoid arthritis with gammalinolenic acid. Ann Intern Med. 1993;119(9):867-73. doi: 10.7326/0003-4819-119-9-199311010-00001.PubMedUsed to support: Randomized double-blind 24-week trial in 37 patients with rheumatoid arthritis and active synovitis comparing 1.4 g/day of GLA in borage seed oil against cottonseed oil placebo, run in a university hospital rheumatology clinic. GLA reduced signs and symptoms (P < 0.05) while placebo patients showed no change or worsened, and overall clinical response across four measures was better on GLA (P < 0.05). Tender joint count fell 36 percent and swollen joint count 28 percent, the placebo group did not improve significantly on any measure, and no one withdrew from GLA for adverse reactions. This is the placebo-controlled trial of borage oil itself for joints; it is small and shares a senior author with the other trials of this group.
  6. Veselinovic M, Vasiljevic D, Vucic V, Arsic A, Petrovic S, Tomic-Lucic A, Savic M, Zivanovic S, Stojic V, Jakovljevic V. Clinical Benefits of n-3 PUFA and ɤ-Linolenic Acid in Patients with Rheumatoid Arthritis. Nutrients. 2017;9(4):325. doi: 10.3390/nu9040325.PubMedUsed to support: Twelve week trial in 60 patients with active rheumatoid arthritis comparing fish oil, fish oil plus evening primrose oil, and no supplementation. Disease activity scores, tender joint counts and pain scores fell in both supplemented groups. Three limits make this weak support for borage oil specifically: the GLA came from evening primrose oil, it was given only together with fish oil so no separate GLA effect can be isolated, and the control group received nothing rather than a placebo, so the comparison was not blinded.
  7. Cameron M, Gagnier JJ, Chrubasik S. Herbal therapy for treating rheumatoid arthritis. Cochrane Database Syst Rev. 2011;2011(2):CD002948. doi: 10.1002/14651858.CD002948.pub2.PubMedUsed to support: Systematic review of 22 randomized trials of herbal treatments for rheumatoid arthritis, including seven trials of GLA from evening primrose, borage or black currant seed oil. The reviewers found moderate evidence that these oils give some relief of pain and disability, and also recorded more adverse events on GLA than on placebo, roughly 20 percent versus 3 percent, a difference that was not statistically significant. Two limits for this page: the benefit is credited to GLA as a class rather than to borage oil specifically, and the pooled trials used doses well above a standard consumer softgel.
  8. De Spirt S, Stahl W, Tronnier H, Sies H, Bejot M, Maurette JM, Heinrich U. Intervention with flaxseed and borage oil supplements modulates skin condition in women. Br J Nutr. 2009;101(3):440-5. doi: 10.1017/S0007114508020321.PubMedUsed to support: Randomized, double-blind, placebo-controlled 12-week study in 45 healthy women with dry, sensitive skin (15 per group) given 2.2 g/day of borage oil, flaxseed oil or a medium-chain fat placebo. Versus placebo, borage oil reduced reddening after a nicotinate irritant (P = 0.03 at 6 and 12 weeks), though the placebo group started lower. Hydration rose in all groups with no difference from placebo; water loss through the skin fell about 10 percent within the borage group and scaling fell from week 0 to 6, but roughness did not change significantly on borage oil, and only flaxseed oil was reported as different from placebo on water loss and roughness. Two authors worked for the supplement maker Laboratoire Oenobiol; the authors declared no conflicts.
  9. Brosche T, Platt D. Effect of borage oil consumption on fatty acid metabolism, transepidermal water loss and skin parameters in elderly people. Arch Gerontol Geriatr. 2000;30(2):139-50. doi: 10.1016/s0167-4943(00)00046-7.PubMedUsed to support: Two-month study in 29 healthy older adults taking borage oil capsules (Quintesal 180, Galderma) supplying 360 or 720 mg of GLA daily, with no placebo group. Water loss through the skin fell by 10.8 percent on average, itch fell from 34 percent of people to none, and reported dry skin fell from 42 to 14 percent, but measured skin hydration did not change significantly. Red blood cell GLA rose about 70 percent and DGLA about 18 percent. Without a control group, change over time cannot be separated from the supplement.
  10. Keen H, Payan J, Allawi J, Walker J, Jamal GA, Weir AI, Henderson LM, Bissessar EA, Watkins PJ, Sampson M. Treatment of diabetic neuropathy with gamma-linolenic acid. The gamma-Linolenic Acid Multicenter Trial Group. Diabetes Care. 1993;16(1):8-15. doi: 10.2337/diacare.16.1.8.PubMedUsed to support: One-year randomized, double-blind, placebo-controlled trial at seven centers in 111 patients with mild diabetic neuropathy given 480 mg/day of GLA. For all 16 nerve function and sensory measures the change was more favorable on GLA than on placebo, and 13 differences were statistically significant; the effect was larger in people with better glucose control. The abstract does not name a borage oil product.
  11. Budeiri D, Li Wan Po A, Dornan JC. Is evening primrose oil of value in the treatment of premenstrual syndrome? Control Clin Trials. 1996;17(1):60-8. doi: 10.1016/0197-2456(95)00082-8.PubMedUsed to support: Review of the placebo controlled trials of evening primrose oil for premenstrual syndrome, of which only seven existed and only five were clearly randomized. The two most rigorous trials showed no benefit, and the reviewers concluded the oil is of little value for premenstrual syndrome. It is cited here because the premenstrual claim made for borage oil is borrowed from evening primrose oil, and the borrowed evidence is negative.
  12. Goyal A, Mansel RE, Efamast Study Group. A randomized multicenter study of gamolenic acid (Efamast) with and without antioxidant vitamins and minerals in the management of mastalgia. Breast J. 2005;11(1):41-7. doi: 10.1111/j.1075-122X.2005.21492.x.PubMedUsed to support: Double-blind placebo-controlled multicenter trial in 555 women with moderate to severe cyclic breast pain, testing GLA (Efamast) with and without antioxidant vitamins and minerals over four menstrual cycles. Pain fell in every arm, including about 40 percent responders on placebo fatty acids, and GLA did not differ from placebo with or without antioxidants. Cited because the breast pain use is borrowed from GLA and evening primrose oil, not tested on borage oil.
  13. Blommers J, de Lange-De Klerk ES, Kuik DJ, Bezemer PD, Meijer S. Evening primrose oil and fish oil for severe chronic mastalgia: a randomized, double-blind, controlled trial. Am J Obstet Gynecol. 2002;187(5):1389-94. doi: 10.1067/mob.2002.127377a.PubMedUsed to support: Six month randomized double blind trial in 120 premenopausal women with severe chronic breast pain comparing evening primrose oil, fish oil, both, and control oils. Days with pain fell about 12 percent on evening primrose oil versus about 14 percent on its control oil, with no meaningful difference between them. A second independent negative result for the breast pain and premenstrual use, again in evening primrose oil rather than borage.
  14. Al-Khamees WA, Schwartz MD, Alrashdi S, Algren AD, Morgan BW. Status epilepticus associated with borage oil ingestion. J Med Toxicol. 2011;7(2):154-7. doi: 10.1007/s13181-011-0135-9.PubMedUsed to support: Case report of status epilepticus in a patient who had been taking borage oil for one week. A single case cannot establish cause and the report gives no dose, but it is the concrete basis for the seizure caution in the safety section, and it is more recent and more specific to borage oil than the 1980s evening primrose oil reports the caution is usually traced to.
  15. Reed GW, Leung K, Rossetti RG, Vanbuskirk S, Sharp JT, Zurier RB. Treatment of rheumatoid arthritis with marine and botanical oils: an 18-month, randomized, and double-blind trial. Evid Based Complement Alternat Med. 2014;2014:857456. doi: 10.1155/2014/857456.PubMedUsed to support: Randomized double-blind 18-month trial with no placebo group: 150 patients with rheumatoid arthritis on stable usual medication received borage seed oil (six capsules supplying 1.8 g/day GLA), fish oil, or both. Disease activity fell significantly in all three groups by 9 months and stayed lower to 18 months, with no significant difference between groups, and study patients cut disease-modifying drugs more than matched registry patients. Without a placebo arm the trial cannot show the oils caused the improvement; it comes from the same research group as the earlier trials, and the authors declared no conflicts.
  16. Takwale A, Tan E, Agarwal S, Barclay G, Ahmed I, Hotchkiss K, Thompson JR, Chapman T, Berth-Jones J. Efficacy and tolerability of borage oil in adults and children with atopic eczema: randomised, double blind, placebo controlled, parallel group trial. BMJ. 2003;327(7428):1385. doi: 10.1136/bmj.327.7428.1385.PubMedUsed to support: Randomized, double-blind, placebo-controlled 12-week trial in 151 adults and children with atopic eczema (140 evaluable, 69 children); adults took borage oil supplying 920 mg GLA a day. The primary sign score improved by 1.4 points more on placebo (P = 0.45), no other assessment differed, and the authors concluded GLA is not beneficial for this condition. Sponsored by Essential Nutrition Ltd, whose director was a co-author.
  17. Puri BK. The safety of evening primrose oil in epilepsy. Prostaglandins Leukot Essent Fatty Acids. 2007;77(2):101-3. doi: 10.1016/j.plefa.2007.07.003.PubMedUsed to support: Review re-examining the two early 1980s reports behind the concern that evening primrose oil can cause seizures; the author concludes the association was spurious and suggests formularies drop seizures as a listed side effect. Cited for the seizure caution, which is weighed against the later borage oil case report.
  18. Vacillotto G, Favretto D, Seraglia R, Pagiotti R, Traldi P, Mattoli L. A rapid and highly specific method to evaluate the presence of pyrrolizidine alkaloids in Borago officinalis seed oil. J Mass Spectrom. 2013;48(10):1078-82. doi: 10.1002/jms.3251.PubMedUsed to support: Analytical study that tested one commercially available borage seed oil for pyrrolizidine alkaloids by high-resolution mass spectrometry; with a detection limit of about 200 parts per trillion, any alkaloids present had to be below that level. One product only, so it does not certify other oils.
  19. Drugs and Lactation Database (LactMed), National Institute of Child Health and Human Development. Borage. Drugs and Lactation Database (LactMed). 2006;Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Revised 2021 Feb 15..PubMedUsed to support: NIH LactMed monograph: borage leaf and flower contain pyrrolizidine alkaloids that are toxic to the liver and lungs and might pass into breast milk; borage seed oil is high in GLA and may contain small amounts of these alkaloids, so only seed oil certified free of them should be used, and leaf products should be avoided while nursing.
  20. European Medicines Agency, Committee on Herbal Medicinal Products (HMPC). Public statement on the use of herbal medicinal products containing toxic, unsaturated pyrrolizidine alkaloids (PAs) including recommendations regarding contamination of herbal medicinal products with PAs. EMA/HMPC/893108/2011 Rev. 1. European Medicines Agency. 2021;EMA/HMPC/893108/2011 Rev. 1, final, adopted 7 July 2021..SourceUsed to support: Official EU agency statement, not PubMed-indexed. Sets an acceptable oral intake of 1.0 microgram a day of toxic unsaturated pyrrolizidine alkaloids for an adult (50 kg), 0.5 microgram for a 20 kg child, also covering pregnant and breastfeeding women; notes the 2014 first version gave 0.35 microgram a day and that EFSA judged a tolerable daily intake inappropriate. Names Borago among plants long known to contain these alkaloids, and describes placental transfer and harm to suckling young in rats and combined liver toxicity with aflatoxin and alcohol in experimental studies.
  21. Belch JJ, Hill A. Evening primrose oil and borage oil in rheumatologic conditions. Am J Clin Nutr. 2000;71(1 Suppl):352S-6S. doi: 10.1093/ajcn/71.1.352s.PubMedUsed to support: Review of the biochemical rationale for GLA oils: GLA raises dihomo-gamma-linolenic acid (DGLA), which forms series-1 prostaglandins such as PGE1 and a 15-hydroxyl derivative that blocks conversion of arachidonic acid to leukotrienes. Cited for the mechanism only.